Health Equity
Medicaid Enrollment Touches 39% of the Residents of The District of Columbia; DC’s 70/30 FMAP is Vital for the Maintenance of Health & Human Services
A reduction in the District’s FMAP would not lead to long-term government savings and would have a ripple effect throughout the entire health system in the DMV, crippling access to care for not only Medicaid beneficiaries but also all those who live, work, and visit the District of Columbia, including members of Congress and their staffs.
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Why does DC receive an Enhanced FMAP Rate?
The DC FMAP rate of 70% established by the Revitalization Act resulted from bipartisan analysis, discussion, and negotiation by Congressional leadership aiming to balance fairness with the District’s restricted ability to generate revenue. Congress recognized that the District of Columbia faces unique financial challenges due to its non-state status and the significant amount of federally-owned land within its boundaries. The District is unable to tax non-residents’ earnings, so these workers pay no taxes to support the infrastructure and services, such as roads, public safety and emergency services that they benefit from in the District. The District is also unable to tax up to 40% of the real property within its borders due to statutory restrictions.
Why are we concerned about DC's FMAP now?
Members of Congress have proposed reducing the DC FMAP to the statutory minimum for all other states, which is currently 50% (but could be reduced even more). Such a change would impact every physician and every practice, regardless of type, location, and payers contracted. Even practices who take no insurance will not be able to send patients for specialist care, hospital admissions, or other types of care.
What can MSDC members do?
- If you know a member of Congress or staffer, reach out to them and share how DC cuts will hurt your patients.
- Share your relationships and outreach with hay@msdc.org so we can help coordinate advocacy efforts.
- Email hay@msdc.org if you would like to be paired with a physician member of Congress office and trained by MSDC staff on how to reach out.
Resources
- DC FMAP cut fact sheet
- California Medical Association fact sheet on Medicaid cuts
- MSDC and healthcare association letter to Congress arguing against DC FMAP changes.
- MSDC original story on Medicaid changes.
News, Statements, and Testimony on Health Equity Issues
CDC: Childhood Vaccinations Plunge During COVID-19
The Centers for Disease Control (CDC) is sounding an alarm that a decrease in childhood vaccinations this spring may lead to multiple public health emergencies.
A report released last week as part of the Morbidity and Mortality Weekly Report noted that on March 13, the president of the United States declared a national emergency. In the weeks following that declaration,the Vaccine Tracking System noted a dramatic decrease in non-influenza and measles-containing vaccines being shipped to providers. The decline was less dramatic in vaccines for children under two-years-old, but there was still an overall decline. The report speculates that stay-at-home orders and fears of COVID-19 infection are prompting parents to delay well-child visits to pediatricians, many of which include vaccinations.
For example, in mid-April, about 1,500 children a week were receiving a measles vaccine. Prior to the public health emergency announcement, that number was about 2,500 per week.
The report notes that as social distancing is relaxed, unvaccinated children are at greater risk to contract diseases like measles. It urges a coordinated campaign between providers and health officials to have children "catch-up" on their vaccine schedule.
The problem is not limited to the United States. The World Health Organization warned that more than 117 million children worldwide were at risk of missing out in the measles vaccine due to COVID-19. In a statement, the American Academy of Pediatrics (AAP) President Sally Goza, MD, FAAP, said, "the COVID-19 pandemic is giving all of us a real-time education in what this vulnerability feels like. Fortunately, we have vaccines to protect children and teens against 16 different diseases."
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